Provider Demographics
NPI:1508132796
Name:BEER, JEFFREY IRWIN (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:IRWIN
Last Name:BEER
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6926 213TH ST
Mailing Address - Street 2:APT. A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2512
Mailing Address - Country:US
Mailing Address - Phone:718-352-0075
Mailing Address - Fax:
Practice Address - Street 1:2 RUSSELL PL
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5245
Practice Address - Country:US
Practice Address - Phone:718-268-7231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-01
Last Update Date:2012-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012296-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1037017Medicaid